34th AM (2023) - Poster Session-Pain Management in Trauma-The Need for Trauma Informed Guideline for Opioid Prescribing

Pain Management in Trauma-The Need for Trauma Informed Guideline for Opioid Prescribing

Pdf Summary

A recent study highlighted the need for trauma-specific guidelines for opioid prescribing in order to improve treatment outcomes and reduce the risk of opioid misuse. The 2022 CDC guidelines focused on monitoring for signs of opioid misuse and the treatment of opioid use disorder, but did not provide guidance on preventing initial opioid misuse. Traumatic injury patients, who often have comorbid mental health and substance use diagnoses, are particularly vulnerable to opioid misuse. The study aimed to examine the use of opioid prescribing guidelines in trauma and acute care surgery (TACS) and identify facilitators and barriers to their utilization from the perspective of TACS providers.<br /><br />The study found that current practices in pain management decision-making for trauma patients lacked trauma-specific guidance and relied on subjective pain scales. There was also a lack of guidance for discharge opioid prescribing. However, local resources, prescription drug monitoring programs (PDMP), and mental health admission screeners were used to assess opioid misuse risk. Clinicians primarily relied on their own clinical judgment, but referred to research and guidelines for best practices. Discharge opioid prescribing was limited to acute pain and follow-up with trauma providers was often lacking, with primary care providers (PCPs) taking over post-discharge pain management.<br /><br />The study highlighted the need for improved federal guidance for both inpatient and discharge care planning for trauma patients. Additional education and support for providers in identifying high-risk patients and managing pain while minimizing the risk of misuse were also recommended. The study also emphasized the importance of patient education and counseling, as well as better standardized language in discharge summaries. The multifactorial nature of trauma and the need for individualized approaches to opioid prescribing were also recognized.<br /><br />In conclusion, there is a need for trauma-specific guidelines for opioid prescribing in order to address the unique needs of trauma patients and reduce the risk of opioid misuse. Further research is needed to identify the contributing factors to opioid misuse in this population and develop effective screening tools and interventions.

Keywords

trauma-specific guidelines

opioid prescribing

treatment outcomes

opioid misuse

subjective pain scales

discharge opioid prescribing

mental health admission screeners

acute pain

federal guidance

individualized approaches

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